Provider Demographics
NPI:1679243588
Name:LITTLE, ADRIENNE
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 MORTHLAND DR STE D
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-4638
Mailing Address - Country:US
Mailing Address - Phone:219-462-9200
Mailing Address - Fax:
Practice Address - Street 1:660 MORTHLAND DR STE D
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-4638
Practice Address - Country:US
Practice Address - Phone:219-462-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health